GP appointment this Wednesday to ask for a referral

Hi, as the topic says I finally have my gp appointment to ask for a referral on Wednesday morning. I have read some of the other threads on here about this subject and taken on board the advice to write down the reasons I believe I fit this diagnosis and why it would benefit me. I'm 35 and have so far failed to hold down a job for more than a few days although I did succeed at University with some difficulties. Before a friend convinced me to look into this and serious consider how well it seems to fit me I had always blamed myself for failing as I genuinely believed I was operating from roughly the same conditions as almost everyone else in the world, and therefore I must really be weak and bad at coping with the world. The last month of reading into this and asking the rest of my family has been a bit shocking as to how different my experience of the world seems to be from the typical, and just how similar they are to a lot of the experiences I have read on blogs and forums. Whilst I am not by any means a genius or savant I have always found it pretty easy to cope academically so I even though I missed quite a bit of time at school due to irritable bowel syndrome etc I think that meant I pretty much flew under the radar.

Anyway I was hoping that if I posted what I have written to show the doctor here people might be willing to give me some constructive feedback as to whether I am waffling too much or not going into enough detail. It comes to about 2 1/4 pages in word. It might still be a bit rough and need a bit of formatting:

My Case for Believing I have Autism Spectrum Disorder

Before I list my reasons for believing I may have Autism Spectrum Disorder I need to explain why I had not come to this conclusion much earlier in life or complained of all the different symptoms before. The simple truth is that I did not know to as when I have mentioned that I do not like certain things or situations across my life and been told “Everybody has some trouble with that” or similar I have taken those comments literally to mean that everyone experiences these things. My default assumption has always been that if this is the case it must just be me that is bad at coping when compared with most other people. I have had a couple of people over the years mention Aspergers to me but since they were not Doctors and I did not seem to meet all of the stereotypes I mostly dismissed the possibility. Within the last couple of months though a friend has encouraged me to take another look and actually read other people’s experiences, which has proved to be extremely enlightening to the point that some of the stories almost seemed to be talking about me. Following this I sat down with my family and asked them questions about how they experience the world and was shocked to discover that a lot of things that really bother me are not experienced by them in the same way.

I know it is not a means of making a diagnosis, but I have taken the Autism Spectrum Quotient (AQ-50) online and scored 46 out of 50, with a score of 32 or above indicating a possibility of being on the autistic spectrum.

I have the following issues in day to day life:

I have sensitive hearing and can often hear things that others struggle to notice such as distant alarms or the hum of some electrical devices, and I am not often able to filter out the background noise in a given situation. To me being at the supermarket for example can be extremely intense with a barrage of different sounds that can feel overwhelming and at times cause me to flinch and almost feel as if it is physically pressing on me. I do not like crowds either both for the noise generated and the sheer number of people and lack of personal space caused. I am also sensitive to the textures of things such as clothing and have always need labels cut out of clothing wherever it will be in direct skin contact and have difficulty tolerating stiff clothing such as jeans or any wool like texture. I can still clearly remember my first day of primary school for the maddening itch that my new school trousers put me through. In terms of textures I am also easily repulsed by certain textures in foods but that is less easy to put into brief words. Encountering them though can easily put me off eating and kill my appetite.

I find having a routine in my day to day life very comforting and need to plan out things in advance. I get annoyed and sulky if my routine is changed by something I did not know about in advance even if it is a pleasant thing such as a spontaneous family outing to get an ice-cream in the summer. If my plan for an appointment or outing is disrupted by something such as the bus being late I get extremely anxious even if I know that it will not affect anything that much simply because the day will not be going as I expected. If I am with someone else this can help a lot but on my own it becomes an extremely unpleasant experience that can make it difficult to function when I get where I need to go. Big changes are incredibly daunting and looking back I have a history of struggling to make successful transitions including primary to secondary school and secondary school to university.

Not knowing exactly what to expect in any given situation can be extremely difficult for me and generates a lot of anxiety, I have found in the course of my life that I am most comfortable when I know exactly what the rules are, what is expected of me and what to expect from anyone that I might have to interact with.

I have difficulties in social situations and I have always struggled to find the words to say exactly why as it is not as simple as saying I get anxious as that anxiety seems to come from how hard I find these situations rather than the situations themselves. I have always had trouble knowing how to react and respond and find reading peoples expressions hard work. It is also extremely difficult to make eye contact and I had trouble getting across why this is during the CBT I had at PSICON as it is not a feeling of fear but rather a strong feeling of discomfort and a powerful urge to look away. The best way I came up with of describing it is it being like struggling to balance on something extremely unstable with it taking a lot of concentration and effort to maintain. I find social situations exhausting because in order to keep track of how everyone is reacting to things takes a huge amount of concentration similar to someone spinning multiple plates and further effort to make small talk and keep track of conversations.

I am sensitive to people’s tone of voice and find that if others around me are depressed or just sound depressed when they speak that I start to feel very depressed as if I am feeling the same way in sympathy. I react to an angry tone of voice by feeling uncomfortable or even scared if they are annoyed enough to be doing things like slamming cupboard doors or banging things down instead of placing them even though I know I am in no danger. I find it extremely difficult if people are upset enough to be crying as I have an overwhelming urge to make things better for them but don’t know how to comfort them. I usually end up standing awkwardly by feeling ashamed at my inability to step in and comfort them. Hugging is extremely awkward, I can tolerate it from my family but physical contact with people I am not very familiar with feels uncomfortably wrong and I usually flinch away.

In a similar way to not knowing how to comfort others I am very bad at showing my own feelings if I am upset in some way. I have a tendency to withdraw into myself and get quiet and I find it extremely difficult to confront people if they are upsetting me as I don’t know where to begin and occasions in my life when I have lost my temper in the past have proved extremely humiliating as I quickly lose the ability to say what I want in a coherent fashion and start to cry.

I have always had extremely focused interests in a small number of things at a time and often find that I forget to do other things that I am supposed to when I am pursuing one of these interests. I can happily spend hours searching for new information and find it very difficult to switch onto a different thing if I need to. I also tend to only be able to have one hobby activity on the go at once; if I am building a model then that gets all of my hobby time until it is complete, and I lose all enthusiasm for other things until then.

The difficulty with doing more than one task at a time does not only apply in my free time as I have found that I have to focus on completing one thing and if I have a complex task with many steps or several things I need to do that things quickly feel overwhelming and I really struggle to see a way to get it all done. It is almost as though a group of tasks can form a hill that I cannot see past to the future and cannot easily see a way to climb it.

Why a Diagnosis Would Benefit Me

A diagnosis would help give me a concrete position from which to try and move forward in life. At the moment I have been unable to get or hold down a paid job since leaving University more than 12 years ago as I very quickly get overwhelmed by everything and become extremely upset. Beyond my immediate family that I live with I have no regular social contacts beyond a good friend online and a few people that I am able to interact with from time to time due to shared hobby interests, although it can easily go months at a time without seeing those people. Until I made the connection between my experience and those I read I had no idea why I struggled to cope in so many situations and my default position in life had been that I must be to blame for failing to cope with the things that I believed everyone had to. This has caused a lot of pain and depression in the past, and I believe contributed to how anxious I get about things due to my past experiences of being burned by events and not understanding why. My suspicion that I may fit this diagnosis has helped me to make a lot of sense of past struggles and events as far back as primary school that have stuck in my mind to this day but it does not provide me the certainty that I need to move forward constructively as it is extremely easy to make me doubt myself partly due to my relatively trusting nature.

Thanks for taking the time to read through this, any feedback good or bad will be appreciated as I am extremely nervous.